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Liver Steatosis
Pasi Erkkilä and Akseli Koskela
Fatty Liver
 Caused by accumulated lipids, mainly triacylglycerol in liver
 Term used when more than 5% of volume of liver tissue is fat
 There is two types of intracellular lipid accumulations
 Microvesicular steatosis
 Small liposomes in the cytoplasm around the nucleus
 Macrovesicular steatosis
 Fat vacuoles grows so large that they push nucleus out of it place
 In normal state liver carries out major lipid metabolism functions, but in fatty
liver following mechanism are disturbed
 Beta-oxidation of fatty acid in mitochondria is decreased
 Fatty acid synthesis in liver or delivery of fatty acid to liver is increased
 Transformation of triglycerides to VLDL and its export is deficient
 In most cases fatty liver is symptomless, but over time it may lead to many
types of liver diseases, such as cirrhosis, hepatocarcinoma and even liver
failure
 Symptoms you may have are:
 Feeling tired
 Loss of weight or appetite
 Nausea
 Weakness
 Confusion, poor judgment or trouble of concentrate
 You may have also other symptoms like over grown liver, abdominal pain and
some skin color changes
 There is no medical cure for disease but you can prevent or cure your
condition by healthy nutrition and physical exercise
 Treatment of diabetes and alcoholism is critical for the treatment of fatty liver
disease
 Usually more common in middle-aged persons who have overweight and
high cholesterol
 Fatty Liver is most common liver disease
 Every 4th adult have it in some point of their lives
 10-20% of normal weight persons and if obese, especially abdominal obese 7080% have it
 There are two main types of fatty liver disease: Nonalcoholic and alcoholic
fatty liver disease
Nonalcoholic Fatty Liver Disease
(NAFLD)
 The most common liver disorder worldwide
 Main cause is central obesity and Type-2 diabetes
 Other reasons includes: Malnutrition, Medication, Viral hepatitis, fast weight
loss and hereditary reasons
 Divided in two categories according to their type of formation
 Type 1, is formed when fatty acids are mobilized from adipose tissue
 Type 2, is formed when the production of lipoproteins is blocked and
triacylglycerol accumulates (in liver)
 In chronic state may lead to Nonalcoholic steatohepatitis (NASH)
 NASH state liver has inflammation and scarring in addition to fat accumulation
 NASH can progress intohepatocarcinoma, liver failure and/or cirrhosis
Alcoholic Liver Disease (ALD)
 Caused by alcoholism, may occur even after short period of heavy drinking
 Develops if person consumes more than 60 g of alcohol per day.
 Eventually leads to cirrhosis (scarring of liver)
 Accumulation is caused by two factors
 Impaired fatty acid oxidation
 Increased lipogenesis
 Alcohol oxidation leads to excess amount of NADH -> free fatty acids form fats
 Other risk factors are:
 Obesity
 High iron concentration
 Hepatitis C
 Heredity factors ( risk of alcoholism and how body breaks down the alcohol)
Acute Fatty Liver of Pregnancy
 Fats accumulate in mothers liver, can be a risk for mother and baby
because may lead kidney or liver failure to either one
 May cause serious infection or bleeding
 Cause uncertain, hormones may play a key role of this
 Fortunately rare cases
Preferences
 Harper´s illustrated biochemistry 30th edition
 http://www.nature.com/modpathol/journal/v20/n1s/full/3800680a.html
 https://en.wikipedia.org/wiki/Steatosis
 http://emedicine.medscape.com/article/175472-overview
 http://www.terveyskirjasto.fi/terveyskirjasto/tk.koti?p_artikkeli=dlk00070&p_h
akusana=rasvamaksa